133 articles - From Friday Apr 07 2023 to Friday Apr 14 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
| Endosc Int Open |
Gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis. G-POEM appears promising as it may provide a cost-effective approach for managing refractory gastroparesis compared to surgical techniques. RCTs are needed to further confirm these results. |
| J Hepatol |
Global incidence of non-alcoholic fatty liver disease: a systematic review and meta-analysis of 63 studies and 1,201,807 persons. NAFLD incidence is increasing with a current estimate of 4,613 new cases per 100,000 years. Males and overweight/obese had significantly higher incidence rates compared to females and those of normal weight. Public health interventions for prevention of NAFLD are needed with a special emphasis on males, overweight/obese persons, and higher risk region. Impact and Implications; Non-alcoholic fatty liver disease (NAFLD) affects approximately 30% of people worldwide and appears to be increasing but data to estimate the incidence rate are limited. In this meta-analytic study of over 1.2 million people, we estimated the incidence rate of NAFLD was 46.13 per 1000 person years with significant differences by sex, BMI, geography, and time-period. As treatment options for NAFLD remain limited, prevention of NAFLD should remain the focus of public health. Studies such as these can help policy makers in determining which and whether their prevention interventions are impactful. |
| J Neurogastroenterol Motil |
Small Intestinal Bacterial Overgrowth Complicating Gastrointestinal Manifestations of Systemic Sclerosis: A Systematic Review and Meta-analysis. There is a 10-fold increased prevalence of SIBO in SSc, with similar SIBO prevalence rates in SSc-subtypes. Antimicrobial therapy of SIBO-positive SSc-patients with diarrhea should be considered. However, the results must be interpreted with caution due to substantial unexplained heterogeneity in the prevalence studies, and the low sensitivity and specificity of the diagnostic tests suggesting that the reliability of the evidence may be low. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Buspirone for early satiety and symptoms of gastroparesis: A multi-centre, randomised, placebo-controlled, double-masked trial (BESST). Patients with moderate-to-severe early satiety/postprandial fullness and other symptoms of gastroparesis did not benefit from buspirone treatment to improve the ES/PPF primary outcome compared with placebo. There was a suggestion of the benefit of buspirone in patients with more severe bloating. |
Evaluation of a downstaging, bidirectional version of the Montreal classification of Crohn's disease: Analysis of 5-year follow-up data from the prospective BioCrohn study. An additional bidirectional disease behaviour assessment capturing reversed or fully controlled complications may provide a more realistic appraisal of the complexity and unmet needs of patients treated with advanced therapies. |
Population-attributable risk of modifiable lifestyle factors to hepatocellular carcinoma: The multi-ethnic cohort. Modifying lifestyle factors, particularly coffee intake, may have a substantial impact on HCC burden in diverse populations, with greater impact among lean adults. Diet and lifestyle counselling should be incorporated into HCC prevention strategies. |
| Am J Gastroenterol |
Age Differences in Core Symptoms and Symptom Relationships in Patients with Irritable Bowel Syndrome: A Network Analysis. Network analysis suggests fatigue is a critical target for symptom management in adults with IBS, regardless of age. Comorbid anxiety is likely an important treatment focus for young adults with IBS. Rome V Criteria update could consider the importance of intestinal gas and bloating symptoms. Additional replication with larger diverse IBS cohorts is warranted to verify our results. |
Association of Anxiety and Gastrointestinal Comorbidities in Repeat Hospital Admissions in Pediatric Cyclic Vomiting Syndrome. 90-day admission rates in pediatric CVS are decreasing overall, although still contributing to significant healthcare expenditure. Anxiety and gastrointestinal comorbidities were associated with increased risk of repeat admissions. Further prospective studies are needed to better understand the complex interactions of these comorbidities and, their management affecting the natural course of CVS. |
Brief Communication: The Contemporary Probability of Occult Colorectal Cancer in Patients with Colitis-Related Dysplasia undergoing Colectomy. It was infrequent in other visible lesions. When present, occult cancer occurred in the same segment as dysplasia, suggesting the historic concern of missing a remote cancer is low. |
Impact of cold snare versus cold forceps resection of diminutive adenomas on segmental incomplete resection rate. S-IRR was 13% higher with CFP resection of diminutive TA than with CSP. A proposed S-IRR metric of <5% is a target goal for al diminutive polyp resection, as 3/12 colonoscopists achieved this low rate. S-IRR can be utilized as a methodology to compare and quantify the difference in segmental metachronous adenoma burden across various polypectomy removal methods. |
Interrater Reliability of Functional Lumen Imaging Probe (FLIP) Panometry and High-Resolution Manometry for Assessment of Esophageal Motility Disorders. Our study demonstrates high levels of interrater agreement and accuracy in interpretation of HRM and FLIP metrics and moderate to high levels for motility classification in FLIP, supporting the use of these approaches for primary or complementary evaluation of esophageal motility disorders. |
No Increased Risk of Cardiac Birth Defects In Infants of Celiac Disease Mothers: a Population and Sibling Comparison. We found no statistically significant risk of any or cardiac birth defects in infants born to mothers with diagnosed CeD compared to the general population and to their non-affected sisters. |
Real-World Validation of a Computer-Aided Diagnosis System for Prediction of Polyp Histology in Colonoscopy: A Prospective Multicenter Study. The overall diagnostic accuracy and sensitivity for neoplastic polyps was higher in experienced endoscopists compared to CADx predictions, with moderate interobserver agreement. Concordance in predictions increased this diagnostic accuracy. Further research is required to improve the performance of CADx and to establish its role in clinical practice. |
Risk of Incident and Fatal Colorectal Cancer after young-onset adenoma diagnosis: a national cohort study. Young-onset advanced adenoma diagnosis was associated with 8-fold increased incident CRC risk compared to normal colonoscopy. However, cumulative CRC incidence and mortality at ten years were relatively low. |
Utilization of Treat-to-Target Monitoring Colonoscopy after Treatment Initiation in the US-Based Study of a Prospective Adult Research Cohort with Inflammatory Bowel Disease (SPARC IBD). About half of SPARC IBD patients received colonoscopy in the 3-15 months following initiation to new IBD treatment, suggesting low uptake of treat-to-target colonoscopy for assessment of mucosal healing in real-world clinical practice. The variation in colonoscopy use between study sites suggests a lack of consensus and a need for more robust evidence associating the practice of routine monitoring colonoscopy with improved patient outcomes. |
What is unspecified functional bowel disorder? A commonly seen, rarely recognized, and poorly understood diagnosis. FBD-U, by Rome IV criteria, is highly prevalent in clinical settings. These patients are not represented in mechanistic studies or clinical trials for not having met Rome IV criteria for other FBDs. Making future Rome criteria less stringent would minimize the number fulfilling criteria for FBD-U and maximize the true representation of FBDs in clinical trials. |
| Clin Gastroenterol Hepatol |
Blood Test Increases Colorectal Cancer Screening in Persons who Declined Colonoscopy and Fecal Immunochemical Test: a Randomized Controlled Trial. Among individuals who previously declined colonoscopy and FIT, offering a blood test as a secondary option increased screening by 7.5% without decreasing uptake of first-line screening options. However, completion of a full screening strategy did not increase. These findings indicate that a blood test is a promising method to improve colorectal cancer screening, but obtaining a timely colonoscopy after a positive non-invasive test remains a challenge; ClincialTrials.gov number, NCT03598166. |
Intraductal papillary mucinous neoplasms in high-risk individuals: incidence, growth rate, and malignancy risk. The cumulative incidence of IPMNs in HRIs is higher than previously reported in the general population. Compared to sporadic IPMNs, they have an increased growth rate. PV carriers with IPMNs are suggested to be at a higher malignancy risk. Intensive follow-up should be considered for PV carriers with an IPMN growing =2.5 mm/year, and surgical resection for those growing =5 mm/year. |
Root-cause analysis of 762 Danish post-colonoscopy colorectal cancer patients. Most PCCRCs originate from possible missed lesions and incompletely resected lesions during the complete study period. These findings indicate the importance of quality assurance of colonoscopy procedures and polypectomy techniques. |
| Endosc Int Open |
Colorectal endoscopic submucosal dissection using the water pressure method for diverticulum-associated lesions: A case series study (with video). WPM allowed for precise procedures in the diverticulum. The feasibility of WPM has been suggested for diverticulum-associated lesions, although cases have been complex. |
Efficacy of the specialized scissor-type knife for gastric endoscopic submucosal dissection: a propensity score matched retrospective study. The SB Knife GX was proven to be useful for control of intraoperative bleeding during gastric ESD, although the procedure time tended to be longer. |
Safety of endoscopic pancreatic necrosectomy compared with percutaneous and surgical necrosectomy: a nationwide inpatient study. Endoscopic necrosectomy is associated with significantly lower risk of inpatient mortality, adverse events, length of stay, and cost when compared to percutaneous and surgical approaches. |
| Endoscopy |
MANDATORY VS. OPTIONAL SPLIT-DOSE BOWEL PREPARATION FOR MORNING COLONOSCOPIES: A PRAGMATIC NON-INFERIORITY RANDOMIZED CONTROLLED TRIAL. Optional SDBP is inferior to the mandatory SDBP in providing adequate BP quality for early morning colonoscopies (8 00am-10 30am), and probably inferior among late morning colonoscopies (10 30am-12 00pm). ClincialTrials.gov number, NCT03650725. |
| Gastroenterology |
Gallstones, cholecystectomy and kidney cancer: observational and Mendelian randomisation results based on large cohorts. Both observational and causal MR estimates based on large prospective cohorts support an increased risk of kidney cancer in gallstone patients. Our findings provide solid evidence for the compelling need to diagnostically rule out kidney cancer before and during gallbladder removal, to prioritise kidney cancer screening in patients undergoing cholecystectomy in their 30s, and to investigate the underlying mechanisms linking gallstones and kidney cancer in future studies. |
MACROPHAGE-DERIVED OSTEOPONTIN (SPP1) PROTECTS FROM NON-ALCOHOLIC STEATOHEPATITIS. MF-derived OPN protects from NASH, by upregulating OSM, which increases ARG2 through STAT3 signaling. Further, the ARG2-mediated increase in FAO reduces steatosis. Therefore, enhancing the OPN-OSM-ARG2 crosstalk between MFs and hepatocytes may be beneficial for NAFLD patients. |
The Long Non-coding RNA Carmn is a Critical Regulator of Gastrointestinal Smooth Muscle Contractile Function and Motility. Our data suggest that Carmn is indispensable for maintaining GI SMC contractile function in mice, and that loss of function of CARMN may contribute to human visceral myopathy. To our knowledge this is the first study showing an essential role of lncRNA in the regulation of visceral SMC phenotype. |
| Gastrointest Endosc |
Benefit of Adjunctive Wide Area Transepithelial Sampling with 3-Dimensional Computer-Assisted Analysis Plus Forceps Biopsy Based on Barrett's Esophagus Segment Length. This study shows that when WATS-3D is added as an adjunct to FB, it is effective at increasing the diagnostic yield of both BE and associated dysplasia in patients with both short and long segments of esophageal columnar-lined epithelium. |
Incidence and Prevalence of Advanced Colorectal Neoplasia in Lynch Syndrome. In a US cohort of LS, advanced neoplasia rarely occurs over annual surveillance. CRC was diagnosed only in MSH2/MLH1 PV carriers. AA occur regardless of PV or LS cancer history. Prospective studies are warranted to confirm our findings. |
| Hepatology |
Antisense oligonucleotide silencing of a glycosyltransferase, Poglut1, improves the liver phenotypes in mouse models of Alagille syndrome. Our preclinical studies establish ASO-mediated POGLUT1 knockdown as a potential therapeutic strategy for ALGS liver disease and possibly other diseases associated with BD paucity. |
Global and national prevalence of nonalcoholic fatty liver disease in adolescents: an analysis of the global burden of disease study 2019. NAFLD in adolescents is an increasing health problem on al continents. Improving environmental factors, including lifestyle but also healthcare policies, can help to prevent NAFLD from developing in children and adolescents and help to improve outcomes in children and adolescents with NAFLD. |
Identification and characterisation of a hepatic IL-13 producing ILC3-like population potentially involved in liver fibrosis. We identified a formerly undescribed subset of IL-13-producing ILC3-like cells that is enriched in the human liver and may be involved in the modulation of chronic liver disease. |
In vivo screening identifies SPP2, a secreted factor that negatively regulates liver regeneration. Using an in vivo CRISPR screening system, we identified SPP2 as a secreted factor that negatively regulates liver regeneration. This study provides new ways to identify, validate, and characterize secreted factors in vivo. |
Intermittent fasting- the future treatment in nash patients? Basic science and clinical studies have shown that apart from inducing body weight loss, improving cardio-metabolic parameters, namely blood pressure, cholesterol and triglyceride levels, insulin and glucose metabolism, IF can reduce inflammatory markers, endoplasmic reticulum (ER) stress, oxidative stress, autophagy, and endothelial dysfunction, as well as modulate gut microbiota. This review aims to further explore the main NASH pathogenetic metabolic drivers on which IF can act upon and improve the prognosis of the disease, and summarize the current clinical evidence. |
Role of HNF4alpha-cMyc interaction in liver regeneration and recovery after acetaminophen-induced acute liver injury. These data show that HNF4a interacts with Nrf2 and promotes GSH replenishment aiding in recovery from APAP-induced liver injury, a process inhibited by cMyc. These studies indicate that maintaining HNF4a function is critical for regeneration and recovery after APAP overdose. |
Semaphorin 3C exacerbates liver fibrosis. Finally, deletion of either SEMA3C or NRP2, specifically in activated HSCs, reduces liver fibrosis in mice. SEMA3C is a novel marker for activated HSCs that plays a fundamental role in the acquisition of the myofibroblastic phenotype and liver fibrosis. |
Targeting senescent hepatocytes using the THBD-PAR1 inhibitor Vorapaxar ameliorates NAFLD progression. The THBD-PAR1 signaling axis is a novel therapeutic target for NASH because blocking this pathway prevents accumulation of senescing but viable hepatocytes that generate factors that promote maladaptive liver repair. |
The role of the gut microbiome in the development of hepatobiliary cancers. Finally, we highlight some emerging gut microbiome editing techniques currently being investigated in the context of hepatobiliary diseases. Although much work remains to be done in determining the relationships between the gut microbiome and hepatobiliary diseases, emerging mechanistic insights are informing novel treatments such as potential microbiota manipulation strategies and guiding public health advice on dietary/lifestyle patterns for the prevention of these lethal cancers. |
| J Hepatol |
A TNFa/Miz1-positive feedback loop inhibits mitophagy in hepatocytes and propagates nonalcoholic steatohepatitis. Our study identified hepatocyte Miz1 as a suppressor of NASH progression and a positive feedback loop of macrophage TNFa-induced degradation of the cytosolic hepatocyte protein Miz1, which results in reduced hepatocyte mitophagy, increased damaged mitochondria and increased TNFa production. Interruption of this positive feedback loop can inhibit the progression of NASH. Impact and implication NASH is a chronic inflammatory disease that can further develop into cirrhosis and HCC. However, the key molecular mechanism of this process has not been fully clarified. Herein, we identified a positive feedback loop of macrophage TNFa-mediated hepatocyte Miz1 degradation, resulting in PRDX6-mediated inhibition of hepatocyte mitophagy, aggravation of mitochondrial damage and increase in macrophage TNFa production. Our findings not only provide mechanistic insight into NASH progression but also provide potential therapeutic targets for NASH patients. Our human NASH liver organoid culture is therefore a useful platform for exploring treatment strategies for NASH development. |
Hepatitis D double reflex testing of all hepatitis B carriers in low HBV and high HBV/high HDV prevalence countries. Double reflex testing is the preferred strategy in low HBV prevalence or high HBV and high HDV prevalence settings. For example, in the European Union and North America only 35,000 and 22,000 will need anti-HDV testing annually. |
| J Neurogastroenterol Motil |
Heart Rate Variability and Somatization in Adolescents With Irritable Bowel Syndrome. Adolescents with IBS showed signs of autonomic dysfunction only during the orthostatic test, which were associated with increased somatization scores. Further research is needed to establish the links between emotional wellbeing and autonomic function in this population. |
Hypercontractile Esophagus: Clinical and Manometric Features From a Multicenter Korean Cohort. Sixty-one percent of patients who meet the diagnostic criteria for the high-resolution manometry are diagnosed with symptomatic HE based CC v4.0. Chest pain and regurgitation were also observed in over half of them. The overall medical treatment efficacy was moderate. |
Prevalence of Irritable Bowel Syndrome in Japan, China, and South Korea: An International Cross-sectional Study. The overall prevalence of IBS in the 3 countries was slightly higher than the global prevalence, and it was significantly lower in China than in Japan and South Korea. IBS prevalence was the highest and lowest among individuals in their 40s and 60s, respectively. Male individuals had a higher prevalence of IBS with diarrhea. Further studies are needed to elucidate the factors associated with this regional heterogeneity. |
Prevalence of Non-erosive Esophageal Phenotypes in Children: A European Multicenter Study. FH may be the most common pediatric NEEP. At long-term follow-up, there was a trend toward a more frequent complete symptom resolution with PPI-therapy in NERD patients while other groups did not benefit from extended acid-suppressive-treatment. |
Protein Kinase CK2 Modulates the Calcium Sensitivity of Type 3 Small-conductance Calcium-activated Potassium Channels in Colonic Platelet-derived Growth Factor Receptor Alpha-positive Cells From Streptozotocin-induced Diabetic Mice. The diabetic oxidative stress-induced upregulation of CK2 contributed to modulating SK3 channel sensitivity to Ca 2+ in colonic PDGFRa + cells, which may result in colonic dysmotility in diabetic mice. |
Pyloric Functional Lumen Imaging Probe Measurements Are Dependent on Balloon Position. FLIP balloon position within the pylorus directly affects balloon geometry which significantly affects P, CSA, and DI measurements. Standardized pyloric FLIP protocols and balloon design adjustments are needed for the continued application of this technology to the pylorus. |
Total Transit Time and Probiotic Persistence in Healthy Adults: A Pilot Study. These results support the notion that host-specific parameters such as WGTT and microbiota composition should be considered when designing studies involving probiotics, especially for the optimization of washout duration in crossover studies but also for the definition of enrollment criteria or supplementation regimen in specific populations. |
Transcriptome and Proteome Profiling of Primary Human Gastric Interstitial Cells of Cajal Predicts Pacemaker Networks. These new and complementary datasets provide a valuable molecular framework for further understanding how ICC pacemaker activity regulates smooth muscle contraction in both normal GI tissue and GI motility disorders. |
| Neurogastroenterol Motil |
ACE and ACE2 catalytic activity in the fecal content along the gut. This work is the first to report the presence of catalytically active ACE and ACE2 in the rat intestinal content, supporting future research on the regulatory role of the intestinal RAAS on gut function and a putative link to the microbiome. |
Children with functional gastrointestinal disorders with and without co-existing nausea: A comparison of clinical and psychological characteristics. Children with nausea, either with or without abdominal pain, report higher somatization scores, increased anxiety and depression, and lower overall QoL, compared to children with pain-related FGIDs without accompanying nausea. Addressing the presence of nausea in children with FGIDs seems essential to customize their treatment and improve overall quality of life. |
Defecatory disorders in patients with type 1 diabetes and chronic constipation. Among T1DCC patients, 37 (32%) had prolonged BET, which was associated with anorectal pressures indicative of a DD but was not associated with reduced rectal sensation, suggesting that DDs are more likely explained by abdomino-anal dyscoordination than visceral disturbance. |
Evaluating the impact of position, volume, and consistency on high-resolution esophageal manometry outcomes. The volume and consistency of a swallow and the position it is performed in, significantly alter HRM metrics. Interpretation of HRM studies should incorporate different normative values which are specific to the position and bolus type. |
Randomized controlled pilot study assessing fructose tolerance during fructose reintroduction in non-constipated irritable bowel syndrome patients successfully treated with a low FODMAP diet. Non-constipated, LFD-responsive IBS patients should be reintroduced to fructose in higher doses than 15 g to assess tolerance. LFD is associated with significant changes in microbial composition and bacterial genes involved in FODMAP metabolism. |
The epidemioflogy and psychological comorbidity of disorders of gut-brain interaction in Australia: Results from the Rome Foundation Global Epidemiology Study. The current study represents the most comprehensive epidemiological exploration of DGBI and mental health in Australia to date, including their prevalence and distributions across sex and age, associations between DGBI and anxiety, depression, and somatization. The findings warrants future comparisons between population characteristics and health care systems differences in order to reduce the burden of DGBI and mental illness worldwide. |
The patient with obstructed defecatory symptoms: Management differs considerably between physicians and surgeons. Practice variation across medical specialties affects diagnostic and management recommendations for patients with ODS, impacting treatment pathways. Our findings provide an incentive toward establishing interdisciplinary, uniform, management guidelines. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
Review article: Available modalities for screening and imaging diagnosis of hepatocellular carcinoma-Current gaps and challenges. The LI-RADS system has standardised the imaging interpretation and diagnosis of HCC. Work remains regarding screening in special populations and optimization of screening modalities. |
Review article: Putting some muscle into sarcopenia-the pathogenesis, assessment and clinical impact of muscle loss in patients with inflammatory bowel disease. Sarcopenia is associated with poor clinical outcomes independent of IBD activity and therefore muscle health should be assessed in al IBD patients at routine intervals. Future studies to better our understanding of the pathophysiology as well as most effective management of sarcopenia in IBD will help guide clinical care and reduce disease related complications. |
Review article: Risk of cardiovascular events in patients with inflammatory bowel disease receiving small molecule drugs. Available evidence of both JAK inhibitors and S1P modulators indicates a reassuring safety profile of SMDs from the cardiovascular perspective in the overall IBD population. Efforts should be made to identify patients with IBD at a higher risk of cardiovascular events. |
| J Hepatol |
| J Neurogastroenterol Motil |
Achalasia: The Current Clinical Dilemma and Possible Pathogenesis. In this paper, epidemiology, diagnosis treatment, as well as possible pathogenesis of achalasia will be reviewed and summarized. The proposed hypothesis on the pathogenesis of achalasia is that genetically susceptible populations potentially have a higher risk of infection with viruses, triggering autoimmune and inflammation responses to inhibitory neurons in lower esophageal sphincter. |
| Neurogastroenterol Motil |
Optimizing nutrition IN pediatric intestinal pseudo-obstruction syndrome. In this review, we discuss current evidence and knowledge regarding nutritional options, implications of the use of different feed types, including a blended diet, and the use of PN. Moreover, based on our experience and the evidence from the literature, we propose a flow chart to guide the nutritional management of PIPO patients. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gut |
| Hepatology |
| J Neurogastroenterol Motil |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gut |
| J Hepatol |
| J Neurogastroenterol Motil |